lecture 2: ROM and stretching Flashcards
what is functional excursion
Distance a muscle is capable of shortening after it’s been maximally elongated
what is the difference between active and passive insuffiecny
active is when agonist is over shortened over a joint and passive is when a multi joint mm is lengthen to his full extent n
what kind of motion is ROM
osteokinematic
when is the difference between active , passive and active assisted ROM
passive is when you move them , active is when they move them selves (mm contraction) and active assisted is u move them and they move themselves
when are the 2 reasons ROM should not be done
when the motion is disruptive to the healing process and when the patient response or condition is life threatening
what are the 7 benefits of CPM
• Prevents development of adhesions, contractures
• Stimulates healing of tendons, ligaments
• Enhances healing of incisions
• Increases synovial fluid lubrication
• Prevents degrading effects of immobilization
• Quicker return of ROM
• Decreases postoperati
when is CPM device applied
immediately after sx
what is the purpose for doing ROM through functional patterns
helps patient realize purpose and value of ROM exercises and assists in developing motor patterns
what is the general ROM exercise for acute tissue healing
PROM 3-5 reps within pain tolerance , several times per day
what is the general ROM exercise for subacute tissue healing
PROM > AAROM> AROM for 10-15 reps with brief hold periods (3-5 seconds) within pain free range; 2-3 times per day
what is the general ROM exercise for chronic tissue healing
AROM: >30 reps for mm re education , maintenance of ROM , stretching to gain ROM
what is the purpose of stretching
increase mobility of soft tissue , improve ROM by enlow acting structures that have adaptively shortened and have become hypo mobile over time
what is the difference between dynamic and passive flexibility
dynamic is flexibility due to active movement and passive is due to a passive force
what is hypo mobility
limited arthrokinematic movement of a joint
how can u gain ROM from arthrokinematics
can make the joint glide which will improve the roll and u will gain ROM
what is contractures designated by
location and position the joint is “stuck in:
what is myostatic contracture
MT unit is adaptively shortened
what is Pseudomyostatic contracture:
Hypertonicity due to CNS lesions: CVA, TBI, SCI
what is Arthrogenic and periarticular contractures:
Adhesions, synovial proliferation, joint effusion, osteophytes
what is Fibrotic contracture and irreversible contractures:
• Fibrous changes in connective tissue leads to adhesions
• Difficult to re-establish normal tissue length
what is Purposefully stretch or mobilize certain muscles and joints while letting others become hypomobile to improve function
Selective Stretching
what is the purpose of overstretching and hypermobility
increase function
what are 8 interventions to increase mobility of soft tissues
-manual or mechanical stretching
-passive stretching
-assisted stretching
-neuromuscular facilitation and inhibition
-muscle energy techniques
-joint mobilization/ manipulation
- soft tissue mobilization and manipulation
-neural tissue mobilization
what type of intervention to increase mobility of soft tissues Utilizes an external force to perform a passive stretch
manual or mechanical stretching
what type of intervention to increase mobility of soft tissue is there No active contraction of the contractile unit
passive stretching
what type of intervention to increase mobility of soft tissue does the Patient assistance by themselves, machine or another person
assisted stretching
neuromuscular facilitation and inhibition for interventions to increase mobility of soft tissues does what 2 tings
• PNF
• Increases or decrease in muscle
tone
what type of intervention to increase mobility of soft tissue uses Passive techniques to restore
arthrokinematics
oint
Mobilization/Manipulation:
what are indications for stretching exercises
• Adhesions, Contractures, Scar Tissue Limit ROM
• Potential for Structural Deformity due to limited ROM
• Muscle Weakness, Shortening of Muscles
• Part of a Total Fitness Program
• Pre and Post Vigorous Exercise
what are the 7 contraindications for stretching exercises
• Bony Block
• Non-Union Fracture
• Acute Inflammation or Infection
• Sharp or Acute Pain With Elongation
• Hematoma or Tissue Trauma
• Hypermobility
• Hypomobility Provides Stability or Neuro-muscular Control
what are the 3 Potential Benefits and Outcomes for Stretching exercises
• Increased Flexibility and ROM
• General Fitness
• Other Potential Benefits
• Injury prevention (evidence not shown for passive stretching techniques)
• Reduced post-exercise soreness
• Enhanced performance
what is the temporary change in tissue length then return to previous length once force is removed
elasticity
viscoelsaticity is only what kind of connective tissue
non contractile
what kind of connective tissue initially resist stress and strain
non contractile
what is the permanent change in tissue length
plasticity
the contractiles tissue response to stretch is determines by what 3 things
velocity , duration and amount of force applied
what type of contractile tissue is Facilitory (Ia afferent)
muscle spindle
what type of contractile tissue is inhibitory (Ib afferent)
glogi tendon organ
Neurophysiological Response of Muscle to Stretch is based on what
velocity, duration and
amount of force applied
what are the 6 types of connective tissue
• Ligaments
• Tendons
• Joint Capsules
• Fasciae
• Non-Contractile Tissue in Muscles
• Skin
what is the composition of connective tissue
-collagen fibers
-elastin fibers
-reticulum fibers
-ground substance
what do elastin fibers allow for
elastic properties of connective tissue
what type of ribs is a type 3 collagen that forms a fibrous mesh or scaffold for other connective tissue types
reticulin fibers
what are the 4 ground substances
GAGs, water, glucosamine, chondroitin sulfate
what is the stress and strain curve used for
interpreting mechanical behavior of connective tissue
what are the 4 things from stress and strain
• Tension
• Compression
• Shear
• Strain
what are the 7 regions of the stress strain curve
- toe region
-elastic range
-elastic limit
-plastic range
-ultimate strength (necking)
-failure
-structural stiffness
what region of the stress strain curve is before the stretch begins and it is “straightening of the collagen fibrils”
toe region
what region int he stress strain surge is the linear phase where if u let go of the stretch it will go back to the length
elastic range
what is the elastic limit int he stress strain surve
transient increase then return to previous length
what region of the stress strain curve will there be permanent increase in length and there is no going back
plastic range
what is the necking region on the stress strain curve mean
warning shock before failure
what part of the stress strain curve does stress (load) increase the most
elastic range
what is creep
load is applied for an extended time to elongate tissue
what kind of load is creep
low load , long duration
what is load is applied for extended time with tissue at constant length
stress relaxation
tissue creep grows from ___ load to ___ load
low to high
stress relaxation goes from ___ load to ___ load
high to low
what is changes in collagen affecting stress strains response
• Effects of immobilization
• Effects of inactivity (decrease of normal activity)
• Effects of age
• Effects of corticosteroids
• Effects of injury
• Other conditions affecting collagen
what are the determinants and types of stretching exercises
-alignment and stabilization
-intensity of stretch
-duration of stretch
-speed of stretch
-frequency of stretch
what are the modes of stretch
• Manual Stretching
• Self-Stretching
• Mechanical Stretching
what are the 3 different types of PNF stretching
• Hold–relax and contract–relax
• Agonist contraction
• Hold–relax with agonist contraction
what is a method of warm up
heat
what is useful for UMN lesions to promote relaxation prior to stretch
cold
what is beneficial after stretch to decrease pain and muscle spasm
cold
what Promotes relaxation of muscles being stretched
biofeedback
what does Joint Traction or Oscillation do
• Inhibits pain
• Promotes muscle relaxation
• Increased inhibitory mechanoreceptor activity
what are the 3 manual stretching techniques in anatomical planes of motion for UE anf LE stretching
• Hand placement
• Patient position
• Procedure
what are the 3 manual stretching techniques in anatomical planes of motion for UE anf LE stretching
• Hand placement
• Patient position
• Procedure
